Sara N Wallace, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4198 Issued in KS

Practice address

111 W 2ND St
Pratt, KS 67124-2644

Phone

(620) 672-6168

Fax

(620) 672-6168

NPI assigned

Nov 21, 2008

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crossings Counseling, LLC

  • Clinical Social Worker
  • Pratt, KS
  • NPI 1992206494
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811142557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W 2ND ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242644",
            "telephone_number": "620-672-6168",
            "fax_number": "620-672-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W 2ND ST",
            "city": "PRATT",
            "state": "KS",
            "postal_code": "671242644",
            "telephone_number": "620-672-6168",
            "fax_number": "620-672-6168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 E 2nd St",
            "address_purpose": "LOCATION",
            "city": "Pratt",
            "state": "KS",
            "postal_code": "671242912",
            "country_code": "US",
            "telephone_number": "620-672-2332",
            "fax_number": "620-672-3162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SARA",
        "middle_name": "N",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098120A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christa Janelle Titus, DNP, FNP-C
• Toetal Care LLC
• Total Renal Care Inc (Pratt Dialysis Center)
• Hannah Vogt
• Amanda Wade, LPC
• Walmart Inc. (Walmart Pharmacy 10-0419)
• Mallory Wang, PHARMD
• Brett Austin Weinbrenner, PMHNP-BC
• Lacie Dawn Werkmeister, APRN-C
• Catherine J Westerhaus, LPC

• Clinical Social Worker in Pratt, KS
• Providers in Pratt, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.